“Better” and “The Checklist Manifesto”

I chanced upon a book called “Better” by Dr. Atul Gawande while browsing in a small bookshop in Rangashankara a few months back. The synopsis looked good, and I picked it up for casual reading. And what a find it was!

Dr. Atul Gawande is a surgeon at Brigham and Women’s Hospital in Boston, and has written extensively in The New Yorker and Slate about medicine and public health. I later also read “The Checklist Manifesto” by the same author, and was very impressed with his writing. Some of the content in the books includes material from his essays. Both books are extremely lucid, and very understandable for a layperson like me. I have not yet read his other books like “Complications”, which are next in my to-read list.

Better” contains a bunch of thought-provoking essays, which deal with various important non-clinical issues in medicine. These articles include topics like the necessity of washing hands when dealing with patients, the enormity of the task of polio vaccination and eradication, the surgeons that deal with war injuries, the dilemma of doctors who are asked to administer the drugs for a death penalty, dealing with insurance and litigations, etc.

The Checklist Manifesto” describes his efforts to promote the use of checklists in the healthcare system in the United States. He uses a number of convincing examples from a variety of fields such as flight pilots in the aviation industry, the construction industry, etc. Just making a laundry list is not enough though. It needs to be structured and worded properly so it is actually useful.

One example given in the book has really stuck with me. He talks of a successful revival case study of a little Austrian girl who had drowned in a pond in the Austrian Alps and was beneath the surface for 30 minutes, and whose heart was not beating for 2 hrs. The checklists and procedures that were put in place by the team of doctors in that remote hospital played a crucial role in executing a perfectly choreographed rescue operation involving a thousand different steps to be performed in a particular order. You can read more about this excellent case study here.

If you like reading medicine related articles/books, I would strongly recommend reading “Better”, as well as some of the articles on his website, www.atulgawande.com.

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